Mobilization of Patients with External Ventriculostomy Drains: Pro and Cons

The effects of prolonged immobilization in the critical patient have been well described. Patients on mechanical ventilation and patients receiving extracorporeal membrane oxygenation therapy have been presented as evidence of the feasibility of implementation of early mobilization protocols. Prolonged immobilization of critically ill patients has been associated with intensive care unit-acquired weakness syndrome, increased mortality, at the cognitive level, impact on quality, and cost increase among other considerations. Early mobilization emphasizes strategies to stimulate motor, sensory, and proprioceptive levels in the context of critically ill patients. Early mobility intervention in critically ill patients begins in the fi rst days of stay in the unit and requires a scheduled combination of passive and active activities. The presence of an external ventriculostomy device is not a contraindication for mobilization. 1,2 It helps as above with the progression and improvement in the outcome. The dislodgement and risk of fracture of external ventricular drainage (EVD) are major concerns. Here, we brie fl y go over the technical aspect of EVD placement and how to safely mobilize the patient.